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Amerigroup is in the complicated business of delivering medical and health care services to 2 million people using public funded programs such as Medicaid, CHIP (children’s health), Medicare, ABD and long-term care programs in 12 states.

Twelve states, 12 sets of rule, multiple databases, multiple benefit programs and cost caps, multiple pharmacy policies, networks providers and equipment suppliers. Inquiries were channeled through four call centers. It took 45 to 50 days to teach customer service reps how to use the system and it was very difficult to get consistency in the quality of the call results, said Russell R. Esposito, senior vice president for information technology services at the company.

“We realized we needed to get some sort of integrated workstation. When we started looking, Pegasystems rose to the top rather quickly on the basis of its functionality.”

Now call center reps work from Compass, an integrated workstation. Their training time has been reduced from 45 days to 20 to 25 days, and the average call from 6 minutes to 5, a 15 percent reduction with increase resolution on the first call.

Esposito said it took some time to explain Pegasystems to senior executives. It is not an application. It integrates data, correlates it, creates dynamic workflows, and comes with a very sophisticated rules engine that can invoke the rules for each product, provider or contractor so the workstation delivers the appropriate answers to the service rep. It’s been a hit with users, he added.

“This is the first time I have ever seen developers go to a training session and get a standing ovation.”

Alan Trefler, CEO of Pegasystems, describes this as customer centric and the company’s products are used in financial services, telecommunications companies, health care providers -- anywhere that vital information is stored in several locations.

“It’s always good to make the complex seem easy, but we have been working on this since 1983. It is easy to talk about but hard to operationalize.” SAP and other ERP vendors talk about data and users might wrap a SaaS (software as a service) layer around it to make the data available to mere mortals who lack computer science degrees. The data sitting deep in ERP systems and databases is important, but it isn’t organized the way customers are. Trefler says it lacks dimensionality. Pegasystems’ solution is the SLC -- which translates into the descriptive but not-so-technical term “Situational Layer Cake.”

Pegasystems organizes data around products, jurisdiction or channel and defines processes, rules and user experience to organize the dimensions.

“Our patented dimensional engine allows you to capture the dimensions of your business intent. This dimensionality fits the needs of complicated customers because it lets you capture business intent across the product silos and across channels and jurisdictions.”

When retailers or health care providers had a more intimate relationship with a small number of customer, they were apt to know the individuals. That was lost as organizations grew to regional and national scale.

“We have now allowed you to recapture and automate the elements that give you a credible way of engaging with your clients more appropriately.”